Filing · f0241
Geisinger Health Plan (all lines of business, aggregated)
Geisinger Health · Medicare Advantage · PA · CY2025
In 2025 this plan received 311,379 standard prior authorization requests and denied 5.1% of them. The median for Medicare Advantage plans of comparable size is 10.9%. One check flagged this filing.
Standard denial rate
5.1%
311,379 standard requests, 15,932 denied.
46.3% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 311,379 | 295,329 | 15,932 | 5.1% |
| Expedited | 3,039 | 2,830 | 168 | 5.5% |
| Extended review, approved | 1,627 | |||
Appeals of standard denials
| Appeals filed | 1,963 |
| Denials overturned | 909 |
| Overturn rate | 46.3% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 0.8 d | 0.0 d |
| Expedited | 0.7 h | 0.0 h |
What the checks found
errorexp_counts_reconcile
2,830 approved + 168 denied = 2,998, but total is 3,039 (41 unaccounted, 1.3%)